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Effect of erythropoietin on the incidence of acute kidney injury following complex valvular heart surgery: a double blind, randomized clinical trial of efficacy and safety

 Ji-Ho Kim  ;  Jae-Kwang Shim  ;  Jong-Wook Song  ;  Young Song  ;  Hye-Bin Kim  ;  Young-Lan Kwak 
 CRITICAL CARE, Vol.17(5) : 254, 2013 
Journal Title
Issue Date
Acute Kidney Injury/epidemiology ; Acute Kidney Injury/prevention & control* ; Biomarkers/blood ; Cardiopulmonary Bypass ; Case-Control Studies ; Double-Blind Method ; Epoetin Alfa ; Erythropoietin/therapeutic use* ; Female ; Heart Valve Diseases/surgery* ; Hematinics/therapeutic use* ; Hematocrit ; Humans ; Incidence ; Kidney Function Tests ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control* ; Recombinant Proteins/therapeutic use ; Risk Factors ; Treatment Outcome
Coronary Artery Bypass Graft ; Acute Kidney Injury ; Renal Injury ; Hydroxyethyl Starch ; Preoperative Risk Factor
INTRODUCTION: Recombinant human erythropoietin (EPO) is known to provide organ protection against ischemia-reperfusion injury through its pleiotropic properties. The aim of this single-site, randomized, case-controlled, and double-blind study was to investigate the effect of pre-emptive EPO administration on the incidence of postoperative acute kidney injury (AKI) in patients with risk factors for AKI undergoing complex valvular heart surgery. METHODS: We studied ninety-eight patients with preoperative risk factors for AKI. The patients were randomly allocated to either the EPO group (n = 49) or the control group (n = 49). The EPO group received 300 IU/kg of EPO intravenously after anesthetic induction. The control group received an equivalent volume of normal saline. AKI was defined as an increase in serum creatinine >0.3 mg/dl or >50% from baseline. Biomarkers of renal injury were serially measured until five days postoperatively. RESULTS: Patient characteristics and operative data, including the duration of cardiopulmonary bypass, were similar between the two groups. Incidence of postoperative AKI (32.7% versus 34.7%, P = 0.831) and biomarkers of renal injury including cystatin C and neutrophil gelatinase-associated lipocalin showed no significant differences between the groups. The postoperative increase in interleukin-6 and myeloperoxidase was similar between the groups. None of the patients developed adverse complications related to EPO administration, including thromboembolic events, throughout the study period. CONCLUSIONS: Intravenous administration of 300 IU/kg of EPO did not provide renal protection in patients who are at increased risk of developing AKI after undergoing complex valvular heart surgery.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Song, Young(송영) ORCID logo https://orcid.org/0000-0003-4597-387X
Song, Jong Wook(송종욱) ORCID logo https://orcid.org/0000-0001-7518-2070
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
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